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Best of 2021: Jack of All Subspecialties

Dec 31, 2021 1:51 pm

Dr. Jack Cush reviews the news and journal articles from the past week on

  1. A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal life or childhood did not increase risk of JIA. #RheumNow

  2. Alendronate may protect against type 2 Diabetes. Data from National Danish Patient Registry, presented at the EASD meeting compared 160k T2DM & 500k controls, T2DM following alendronate adjusted OR=0.64; 0.62-0.66; >8yrs OR=0.47

  3. Analysis of 508 #RA pts (over 10 yrs) in the BeST study shows joint swelling at baseline resulted in half w/ re-swelling later and significantly increased risk of same joint swelling during follow-up (OR 2.37, 95% CI 2.30 to 2.43, p<0.001)

  4. Finnish Pop study 939 #RA pts shows highest healthcare costs linked to high Dz activity & comorbidity. Clusters: C1) young w/ low costs & activity, C2) chronic pain, disability, fatigue, C3) high cost/dz activity, less pain, C4)comorbidities w/ $$$

  5. A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern. Read more…

  6. Case controlled study suggests that intraarticular steroid injections is associated with increased (HR 8.56; 3.29-22.3) risk of rapidly destructive hip disease (RDHD); at a rate of 5.4% (5.1 mos post injx) w/ JSN, osteolysis, fem head collapse

  7. Biosimilar update: 31 FDA approved biosimilars, but only 60% made it to market. 2015 to 2019, drug spending grew 6.1%, biologic spending grew 14.6%; biologics are 43% of US drug spending. Most biosimilars at ~30% discount.

  8. Study Finds U.S. Generic and Biosimilar Savings Totaled a Record $338 Billion in 2020

  9. Can I get the INFLUENZA and COVID Vaccines together? The CDC says: "YES...both vaccines can be given at the same visit, people should follow the recommended schedule for either vaccine.... ideally get a flu vaccine by the end of October."

  10. MMWR shows the safety of a 3rd (booster) dose of the mRNA vaccine to be same as the 2nd dose AEs. V-safe data on 3rd dose (n=12,591) showed local or systemic effects (79% or 74%) to be same as 2nd dose (78% or 76%)

  11. CDC Advises COVID-19 Vaccines for Pregnant Women

  12. U.S. Preventive Services Task Force (USPSTF) reaffirmed its recommendations that pregnant women at a high risk of preeclampsia should take a daily aspirin regimen at the end of the first trimester

  13. Is Acetaminophen Potentially Hazardous in Pregnancy?

  14. #RA patients had an an increased risk of mortality after CABG (HR 1.50; 1.28-1.77); and a higher risk of MI following CABG (HR 1.61; 1.28-2.04). A retrospective Finnish study comparing RA (n= 378) to nonRA patients (n = 7560)

  15. Early Diastolic Dysfunction in Premenopausal Women with RA…

  16. 108 pts with autoimmune cytopenias (TTP, ITP, AIHA, etc) were given COVID vaccination showing low rate of post-vax flares. Signif HEME decreases in 7.4% of AIHA & ITP; mild decrease in 10% AIHA and 20% ITP, w/ no Rx change

  17. Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib)

  18. Questions & Cases

    • Approach to dental surgery while on bisphosphonate
    • Recurrent shingles while on adalimumab
    • Myositis after COVID-19 vaccine

Editor's note: This post originally appeared October 1, 2021 and is being republished as part of RheumNow's Best of 2021. 

The author has received compensation as an advisor or consultant on this subject

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